by William Cutrer, MD, and Sandra Glahn, ThM

They’re the frozen unchosen. Children on ice. Frozen babies, if you will. A couple engages in a custody battle over their unused frozen embryos. Meanwhile some researchers want to destroy “extra” embryos in hopes of curing diseases. And while some infertile women pray for their eggs to fertilize in IVF cycles, others give permission to have their “excess” embryos destroyed. Bring up the topic of “infertility,” and invariably someone will mention these sorts of ethical quagmires—pulled straight from the headlines.

In the process of creating a child together, why are couples often so willing to enter such a complex maze of moral dilemmas? Because, simply put, infertility is hard stuff. God’s first command to Adam and Eve related to conceiving children, and most couples dream about their union producing a child who is the product of their love. Wrapped up in childlessness, then, are unfulfilled longings and the death of precious dreams. Ever since the Fall, after which God told Eve he would multiply her pain in conception and childbirth, we see problems with human reproduction. Researchers have determined that the depression and anxiety infertile couples experience are equivalent to the pain suffered by patients suffering from terminal illness. Proverbs 30:16 hints at this when it tells us that a “barren womb” is among four things on earth that are “never satisfied.”

What exactly is infertility? Defined medically, it’s the inability to conceive or carry a child to term after one year of unprotected intercourse. It has many causes, but the idea that “infertile couples just need to relax and they’ll get pregnant” is a myth. In ninety-five percent of cases, there’s a diagnosable medical reason. Fertility problems are as common in men as in women, and the number of couples appears to be on the rise due in part to delayed childbearing, sexually transmitted diseases, and environmental factors.

What Can Couples Do About It?

Some argue that infertility is a matter of “God closing the womb” (e.g., Sarah, Hannah), thus insisting that faith alone should be sufficient. Others believe that, while God is able to open and close wombs, He has permitted limited insight into the complex functioning of the human body. (Few would accuse doctors of “meddling” when they treat diabetes with insulin, infection with antibiotics, or cancer with chemotherapy.) Recognizing that approximately sixty percent of couples pursuing treatment will go on to experience live birth, those in favor of medical treatment argue that therapy is appropriate as long as no scriptural principle is violated. Admittedly, scriptural principles are sometimes violated, as is evidenced by the uproar about researchers using stem cells from destroyed embryos, mostly obtained from fertility clinics. So for couples believing that some medical treatment can fall within the will of God, the next question is this: how far can or should we go with such intervention?

Medication – Based on the premise that drug therapies qualify as moral, many treatment options qualify as “fertility enhancing.” A simple course of antibiotics can be “fertility treatment” for the man with a prostate infection. Replacement hormone may be a “fertility drug” for a woman with low thyroid. Yet when we talk of fertility drugs, we usually mean specific ovulation-inducing medications. These hormones may bypass built-in protective mechanisms, resulting in the maturation of multiple eggs. Careful monitoring with ultrasound can help avoid multiple births and some ethical dilemmas.

Surgical intervention – Diagnostic surgery can uncover hidden causes of infertility, and corrective surgery often helps. Surgeons may, for example, correct fallopian tube blockage or endometriosis, which affects the uterine lining. In men, surgery can reverse vasectomies or repair structural damage and varicose veins in the testicles.

High Tech Options – Many Bible-believing Christians approve the use of artificial insemination, in vitro fertilization, and other high tech procedures, provided the egg and sperm come from the married partners and precautions are taken to honor life even at the one-celled stage. Couples using in vitro fertilization should limit the number of eggs fertilized to the number of babies they are willing to carry to term. By doing so they avoid having to later decide both about the destruction of “excess” embryos and about “selective reduction” in cases where the pregnancy results in six or seven babies. Some couples opt for freezing embryos; others have reservations about cryopreservation, feeling that it exposes the embryo to unnecessary risk and that it presumes on the couple’s future. At the very least, couples cryopreserving embryos should have a plan for carrying each one to term.

Adoption – Pharaoh’s daughter adopted Moses. A family member adopted Esther when her parents died. God calls all those who believe in Christ his children through adoption. Thus, the Bible draws a beautiful picture of the adoption relationship.

Of the many losses in infertility, adoption is the solution for only one—the loss of the ability to parent the next generation. Successful “embryo adoption” brings with it the addition of the pregnancy, birth, and nursing experiences not possible in traditional adoption arrangements. Yet the genetic family traits of husband and wife are not passed down. While not a great option in an ideal world, embryo adoption does provide a solution for couples who have chosen to have embryos cryopreserved but who want to avoid authorizing their destruction. Consider the couple who had eight embryos created during an IVF cycle. Doctors implanted three in the wife’s uterus and froze five. After she had triplets, the wife had emergency surgery to remove her uterus. That left this couple with three choices—to allow embryo destruction, find a surrogate, or connect with someone willing to “adopt” them.

Embryo adoption is relatively new—developed because of the more than 100,000 frozen embryos in the U.S. alone. One Christian embryo adoption program works like a full-service adoption agency connecting couples wanting to carry these embryos with couples who have “extras.” At the moment this costs about $6,000. However, some Internet services charge less than $75/month for these couples to advertise and connect with each other.

Most experts encourage couples who pursue infertility treatment to exhaust medical options before pursuing adoption—whether traditional or with frozen embryos—as going through infertility and adoption require working through separate sets of losses. This is why so many infertile couples find it aggravating when others tell them, “You can always adopt.”

Infertile couples usually grieve deeply the loss of a jointly created child. For them, adoption will never fill this void. However, once they reach the “resolution” stage of their infertility, other options look more appealing. Only then can adoption become a wonderful means of seeing their dreams and longings come to life.

Additional Question/Answer about Infertility:

Do most infertile couples seek such high-tech treatment?

No. Approximately five percent of infertile couples seek reproductive technologies as a means of resolving their fertility problems. The number of Christian couples pursuing these treatments is probably significantly lower than that. Probably most of these passively resign themselves to the “will of God,” often hesitating to seek even the simplest forms of treatment.

Is it wrong to pursue medical treatment for a fertility problem?

Not necessarily. Beginning with the premise that producing offspring is good and moral—clear from God’s command to the first couple to “be fruitful and multiply” (Genesis 1:22)—couples begin by asking if any medical intervention is moral. Some argue that infertility is a matter of “God closing the womb” (Sarah, Hannah, etc.) and they go on to insist that faith alone should be sufficient in all areas of life.

Others believe that, while God is able to open and close wombs, He has permitted limited insight into the complex functioning of the human body. Recognizing that approximately ninety-five percent of infertility cases stem from diagnosable medical conditions and that approximately sixty percent of couples pursuing treatment will go on to experience live birth, they argue that medical therapy is appropriate as long as no one violates scriptural principles. We would say that in the same way we would support using antibiotics for infections and chemotherapy for cancers, we use medical intervention to cure fertility problems. One biblical support for this would be that Paul told Timothy to take wine for his stomach’s sake (1 Tim. 5:23).

What can be done with fertility drugs?

Specific ovulation-inducing medications constitute what most call “fertility drugs.” These hormones bypass built-in protective mechanisms, resulting in the maturation of multiple eggs. Drug therapy for the male has been less encouraging. But in those men helped by drug therapy, we find no additional risk of multiple pregnancies, as the human egg normally allows only one sperm to penetrate.

For couples believing medical treatment can fall within the will of God, the next question is this: how far can or should we go with such intervention and still honor the Lord?

Join us in the next column as we explore this question.